Provider Demographics
NPI:1215719513
Name:TARASHUK, MEAGHAN (LCSW)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:TARASHUK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:
Other - Last Name:MELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:56 ALDRICH ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-2758
Mailing Address - Country:US
Mailing Address - Phone:617-850-2765
Mailing Address - Fax:
Practice Address - Street 1:200 SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1114
Practice Address - Country:US
Practice Address - Phone:781-506-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2272091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical